Multicentric hepatocarcinogenesis at 6 and 13 years after sustained viral response to hepatitis C virus

A 68-year-old Japanese woman with chronic hepatitis C infection who achieved sustained viral response (SVR) was followed up regularly. Six years after SVR, alpha fetoprotein (AFP) was increased. Hepatocellular carcinoma (HCC) was diagnosed by computed tomography and was excised by hepatic resection. Thirteen years after SVR, AFP increased again, and HCC recurrence was detected, which was excised by hepatic resection. Each HCC was <2 cm in diameter, with no vascular invasion. The primary HCC was moderately differentiated, while the secondary was well-to-moderately differentiated. Based on the clinicopathological features, the hepatocarcinogenesis was considered multicentric. Our case illustrates the importance of long-term follow-up of patients who achieve SVR.